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More pain, less gain
  1. Margreth Grotle1,2,
  2. Peter Croft3
  1. 1FORMI (Communication Unit for Musculoskeletal Disorders), Division for Neuroscience and Musculoskeletal Medicine, Oslo University Hospital, Ullevaal, Oslo, Norway
  2. 2National Resource Centre for Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
  3. 3Primary Care Epidemiology, Arthritis Research Campaign National Primary Care Centre, Keele University, Keele, UK
  1. Correspondence to Professor Peter Croft, Primary Care Epidemiology, Arthritis Research Campaign National Primary Care Centre, Keele University, Keele ST5 5BG, UK; p.r.croft{at}keele.ac.uk

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In this issue of Occupational and Environmental Medicine, Miranda et al1 (see page 449) present evidence that musculoskeletal pain at multiple sites is associated with self-rated work ability and plans to retire early among actively working people. They use data from a large national health examination survey in Finland, in which an extensive range of demographic, physical, psychological and social variables were examined among employed people between 30 and 64 years of age. They find that multi-site musculoskeletal pain is a common phenomenon among working people and that this poses a considerable threat to work ability.

The results fit well into the increasing body of literature indicating that pain in multiple sites is common in the general population.2 The proportion of people in the new study who had multi-site pain is rather lower than estimates from other studies, probably reflecting that Miranda et al only included musculoskeletal pain and that theirs was a working population. Even so, 33% of these adults had musculoskeletal pain in more than one site. The evidence is clear that, for clinical and epidemiological practice, we should be moving from an exclusive concentration on single-site pain syndromes (back pain, neck pain, shoulder pain and so on), and from regarding risk factors for their onset or poor prognosis as distinct and exclusive to each syndrome, towards a …

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